Garg Deepika, Tal Reshef
Department of Obstetrics and Gynecology, Maimonides Medical Center, Brooklyn, NY, USA.
Division of Reproductive Endocrinology & Infertility, Department of Obstetrics, Gynecology and Reproductive Sciences, Yale University School of Medicine, New Haven, CT, USA.
Int J Endocrinol. 2016;2016:1979654. doi: 10.1155/2016/1979654. Epub 2016 Oct 4.
Polycystic ovary syndrome (PCOS) affects 5-10% of women in reproductive age and is characterized by oligo/amenorrhea, androgen excess, insulin resistance, and typical polycystic ovarian morphology. It is the most common cause of infertility secondary to ovulatory dysfunction. The underlying etiology is still unknown but is believed to be multifactorial. Insulin-sensitizing compounds such as inositol, a B-complex vitamin, and its stereoisomers (myo-inositol and D-chiro-inositol) have been studied as an effective treatment of PCOS. Administration of inositol in PCOS has been shown to improve not only the metabolic and hormonal parameters but also ovarian function and the response to assisted-reproductive technology (ART). Accumulating evidence suggests that it is also capable of improving folliculogenesis and embryo quality and increasing the mature oocyte yield following ovarian stimulation for ART in women with PCOS. In the current review, we collate the evidence and summarize our current knowledge on ovarian stimulation and ART outcomes following inositol treatment in women with PCOS undergoing in vitro fertilization (IVF) and/or intracytoplasmic sperm injection (ICSI).
多囊卵巢综合征(PCOS)影响5%-10%的育龄女性,其特征为月经稀发/闭经、雄激素过多、胰岛素抵抗以及典型的多囊卵巢形态。它是排卵功能障碍继发不孕的最常见原因。其潜在病因仍不清楚,但被认为是多因素的。胰岛素增敏化合物,如肌醇(一种B族维生素)及其立体异构体(肌醇和D-手性肌醇)已被研究作为PCOS的有效治疗方法。在PCOS中给予肌醇已被证明不仅能改善代谢和激素参数,还能改善卵巢功能以及对辅助生殖技术(ART)的反应。越来越多的证据表明,它还能够改善卵泡生成和胚胎质量,并在PCOS女性接受ART卵巢刺激后提高成熟卵母细胞产量。在当前综述中,我们整理了证据,并总结了我们目前对接受体外受精(IVF)和/或卵胞浆内单精子注射(ICSI)的PCOS女性在肌醇治疗后的卵巢刺激和ART结局的认识。